Group B Streptococcus Lab Test

Group B Streptococcus (GBS) is the most common cause of life-threatening infections in newborn babies in the UK.

This kit contains everything you need to test for GBS and safeguard your baby's health.

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What is Group B Streptococcus?

Group B Streptococcus (GBS) is a normal bacterium which is carried by 20-40% of adults, most commonly in the gut and the vagina.

Most carriers do not know they have it as it is usually without symptoms.

GBS is common in pregnant woman and can be passed from mother to baby during labour, rarely causing any problems. However, for a small number of babies it can be life-threatening, causing blood poisoning, pneumonia and meningitis.

Why should I test for Group B Streptococcus?

Group B Streptococcus (GBS), is the UK's most common cause of life-threatening infections in newborn babies, and meningitis in babies up to the age of 3 months.

The test helps to detect women carrying GBS, who are more at risk of passing the bacteria onto their baby during labour.

Screening for GBS is not routinely offered on the NHS, but laboratory testing is commonly undertaken at The Doctors Laboratory (www.tdlpathology.com) using the GBS-specific Enriched Culture Medium (ECM) test.

The GBS-specific ECM is the international ‘gold standard’ for
detecting GBS carriage and means taking swab samples from the low vagina and rectum
which are sent off to the lab for analysis.

These tests are highly reliable and are good predictors of your GBS carriage status for 5 weeks after the swabs have been taken. The ECM test is the test recommended for use by the Royal College of Obstetricians& Gynaecologists for women who carried GBS in their previous pregnancy.

Thousands of babies are exposed to GBS with no consequence. It is not known why some babies are susceptible to the bacteria and develop infection.

By testing for GBS and the mother receiving treatment (via intravenous antibiotics), the bacteria can be prevented from passing to the baby during labour and prevent life-threatening infections.

If a woman who carries GBS is given the recommended antibiotics in labour, the baby’s risk is reduced by an estimated 85-90%.

Who should test for GBS?

Any pregnant woman between 35 and 37 weeks of pregnancy.

GBS can come and go during pregnancy but the ECM test has been found to
be a good predictor of your GBS carriage status for the 5 weeks following
testing, so the aim is to test in the 5 weeks before you go into labour and
give birth. So the 35-37 week ‘window’ for testing is usually thought to
be the best time to test for most people, as your GBS carriage status is
not likely to change between testing and giving birth, and you should
receive the result before your baby arrives.

If you are or have recently taken antibiotics, this may affect the test result so discuss this with your midwife or doctor. If you can, leave it for a couple of weeks after completing the course of antibiotics before testing.

Will I be offered a test on the NHS?

Screening for GBS is not routinely offered on
the NHS but if a pregnant woman is offered testing it’s usually the Standard
‘non-selective’ test for group B Strep carriage.

A negative result using this method is not very
reliable – it gives a high proportion of falsely negative results.

GBS will be isolated in only up to 50% of cases where the
Mum is carrying GBS. This test is unselective – other bacteria present on the
swab may outgrow and ‘swamp’ the GBS sample.

Many health professionals and most pregnant women are unaware of just how high the false-negative rate is for these tests.

Can GBS always be prevented?

There are two types of GBS infection in newborns, early and late-onset.

About two thirds of GBS
infections in babies are early-onset (developing in the baby’s first 6 days of
life) where a significant symptom is the rapid development of
breathing problems, associated with blood poisoning.

The remaining third are
late-onset, occurring after the baby’s first 6 days and can be responsible for sepsis
and meningitis.

Most GBS infections show in
the first 2 days of life, they are uncommon after a baby reaches one month old
and very rare after age three months. Although intravenous
antibiotics in labour are very effective at reducing the chance of a baby
developing early-onset GBS infection, currently there are no known ways of
preventing late-onset GBS infections.

GBS is recognised
to cause preterm delivery, maternal infections, stillbirths and late
miscarriages; preterm babies are known to be at particular risk of GBS
infection as their immune systems are not as well developed.

Overall, even with
current prevention strategies, approximately 1 in every 1,000 babies born in
the UK develops group B Strep infection.

What are the risks of GBS during pregnancy?

GBS is recognised to cause preterm delivery, maternal infections, stillbirths and late miscarriages; preterm babies are known to be at particular risk of GBS infection as their immune systems are not as well developed.

Overall, even with current prevention strategies, approximately 1 in every 1,000 babies born in the UK develops group B Strep infection.

How do I take the test?

Two swabs need to be taken (rectal and vaginal). It doesn't matter which swab you use for which, but they need to be labelled correctly. Also, its important that you do not touch the cotton end with your fingers or let it come into contact with other surfaces (for example, clothing, tables or towels).

Each sample must be labelled, indicating whether it's a vaginal or rectal swab, and you must fill in your name, date of birth and the date of taking the sample.

There are full instructions supplied with each test kit.

Your test results will be received 3 days after the lab receives your test samples.

What happens if I have GBS?

Positive Test
Results

If
you have received a positive test result, tell your health professional.

You should be offered intravenous
antibiotics as soon as possible from the start of labour (and usually 4-hourly)
until delivery. Your health professional should discuss this with you.

It’s very important that, if you
are allergic to penicillin or any other antibiotic, you tell your healthcare
professional.

Negative Test
Results

A negative ECM test result
within 5 weeks of delivery means you would not be offered intravenous
antibiotics in labour against GBS infection in your newborn baby unless known
risk factors are present.

What are the symptoms of GBS?

In the UK, up to
two-thirds of GBS disease is early onset (showing within the
first week).

Early-onset GBS
infection usually presents as sepsis with pneumonia. These “early-onset”
infections are usually apparent at or soon after birth, with the typical signs
including :-

Being unresponsive/floppy

Very fast heartrate

Very slow heartrate

Making grunting noises when breathing

An unusually high temperature

And unusually low temperature

Very fast breathing

Very slow breathing

Call 999 or go to your local A&E if your baby gets any of these symptoms after discharge from hospital. However, most early-onset GBS infections show symptoms within the first 12 hours after birth so will often be identified at the maternity unit.

Late onset GBS infection (age 7-90 days old)

Up to a third of
GBS infections in babies are late-onset, occurring after the baby’s first 6
days, usually as meningitis with sepsis. It is uncommon after a baby
reaches one month old and very rare after age three months.

Typical signs of
late-onset group B Strep infection are similar to those associated with early
onset infection and may include signs associated with meningitis such as :-